Presentation of clinically suspected persistent chlamydial infection: a case series.

Abstract:

:In vivo antimicrobial resistance has yet to be documented in Chlamydia trachomatis; however, there have been anecdotal reports of persistent infection. The purpose of this case series was to describe a group of patients who have persistent chlamydia infection despite adequate treatment and where re-infection was considered unlikely. Patients were selected using a clinical questionnaire. For inclusion patients had to have tested positive for C. trachomatis, at least twice, using a nucleic acid amplification test despite having been fully compliant with at least two rounds of recommended therapy and be deemed to be at low risk of re-infection. Patients were grouped into categories based on sexual behaviour. Twenty-eight patients are included in this case series; 46% declared no sexual contact since initial diagnosis (category 1), a further 36% declaring contact that was considered low risk of re-infection (categories 2-4); 61% showed signs and symptoms at initial presentation increasing to 75% at re-attendance. Thirty-nine percent of patients received azithromycin only while 48% received doxycycline also. This case series identifies patients with persistent chlamydia despite receiving treatment. There is a need for a case definition of clinical treatment failure, development of susceptibility testing methods and guidance on appropriate treatment for patients with persistent infection.

journal_name

Int J STD AIDS

authors

Pitt RA,Alexander S,Horner PJ,Ison CA

doi

10.1177/0956462412472815

subject

Has Abstract

pub_date

2013-06-01 00:00:00

pages

469-75

issue

6

eissn

0956-4624

issn

1758-1052

pii

0956462412472815

journal_volume

24

pub_type

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